scholarly journals The Rate and Risk Factors of Acute Kidney Injury among Cancer Patients’ Admissions in Palestine: A Single-Center Study

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Zaher Nazzal ◽  
Fatima Abdeljaleel ◽  
Aseel Ashayer ◽  
Husam Salameh ◽  
Zakaria Hamdan

Introduction. Acute kidney injury (AKI) remains a critical issue for cancer patients despite recent treatment improvements. This study aimed to assess the incidence of AKI in cancer patients and its related risk factors. Methods. A Retrospective cohort study was conducted at tertiary hospitals in the period 2016–2018. A data abstraction sheet was used to collect related variables from patients’ records. During admission, the incidence of AKI was assessed using creatinine measurements. RIFLE criteria were used to classify it into five categories of severity: risk, injury, failure, loss, and end-stage renal disease. Results. Using RIFLE (Risk, Injury, Failure, Loss, and End-stage renal disease) criteria, 6.9% of admissions were complicated with AKI. The severity of these fell into the categories of risk, injury, and failure, 3.3%, 1.7%, and 1.9%, respectively. In the multivariate model, the odds for developing AKI was significantly higher for patients with congestive heart failure (AOR = 17.1, 95% CI 1.7–80.1), chronic kidney disease (adjusted OR = 6.8, 95% CI 1.4–32.2 ( P value 0.017)), sepsis (AOR = 4.4, 95% CI 1.9–10.1), hypercalcemia (AOR = 8.4, 95% CI 1.3–46.1), and admission to the ICU (AOR = 5.8, 95% CI 2.1–16.2). In addition, the mortality rate was nearly seven times higher for patients complicated by AKI (relative risk = 7.6, 95% CI 3.2–18.2). Conclusion. AKI was significantly associated with congestive heart failure, chronic kidney disease, sepsis, ICU admission, and hypercalcemia in cancer patients, resulting in poorer outcomes and higher mortality rates. AKI assessment for hospitalized cancer patients should be performed regularly, especially for patients at increased risk.

Author(s):  
SHAREEF J. ◽  
SRIDHAR S. B. ◽  
SHARIFF A.

Proton pump inhibitors (PPIs) are most widely used medications for acid related gastrointestinal disorders. Accessible evidence based studies suggest that the increased use of PPI is linked to a greater risk of developing kidney diseases. This review aims to determine the association of kidney disease with the use of proton pump inhibitor with various study designs. PubMed, Scopus and Google Scholar databases as well as a reference list of relevant articles were systematically searched for studies by using the following search terms; ‘proton pump inhibitors’, ‘acute kidney injury’, ‘chronic kidney disease’ and ‘end stage renal disease’. Both observational and randomized controlled trials (RCTs) exploring the association of PPI use with kidney disease were eligible for inclusion. A total of 8 articles, including 9 studies (n = 794,349 participants) were identified and included in the review. Majority of the studies showed a higher risk of kidney outcomes in patients taking PPIs, with effect higher of acute kidney injury (4-to 6-fold) compared with chronic kidney disease and end stage renal disease (1.5-to 2.5-fold). However, the studies suggest that the strength of evidence is weak and could not prove causation. The risk increased considerably with the use of high dose of PPIs and prolonged duration of exposure necessitates the monitoring of renal function. Exercising vigilance in PPI use and cessation of proton pump inhibitor when there is no clear indication may be a reasonable approach to reduce the population burden of kidney diseases.


Author(s):  
Coilin Smyth ◽  
Sinead Galvin

This chapter on the topic of cardiac surgery–associated acute kidney injury (CS-AKI) examines the risk factors for and the prevention, diagnosis, and management of this serious and common consequence of cardiothoracic surgery. The chapter follows the clinical course of a patient with a moderate risk of CS-AKI undergoing an aortic valve replacement and coronary artery bypass grafting. The risk factors, both patient- and surgery-specific, are demonstrated in tabular form. Methods to mitigate against these risk factors are explained, including optimizing the timing of surgery. The most up-to-date diagnostic criteria for AKI are compared. It also recommends the most accurate formulae to evaluate the severity of CS-AKI. The value of medical therapies prior to renal replacement therapy (RRT) is examined. The clinical decisions regarding the mode of RRT, timing of RRT, anticoagulation methods, and vascular access are highlighted. Patients with already established end-stage renal disease are discussed as a separate cohort. The chapter concludes by discussing the short- and longer-term prognosis associated with CS-AKI.


Author(s):  
Aminu Bello ◽  
Marcello Tonelli ◽  
Kitty Jager

Renal epidemiology has moved from a focus on patients treated with renal replacement therapy using data from renal registries, to a much broader view of acute and chronic kidney disease. A review of essential epidemiological concepts and principles is followed by discussion of the epidemiology of different types of kidney disease: acute kidney injury, chronic kidney disease, and end-stage renal disease. The chapter concludes with a section on future challenges and potential solutions.


2019 ◽  
pp. 193-200
Author(s):  
Sara Samoni ◽  
Claudio Ronco

In the absence of any effective pharmacologic therapies, severe acute kidney injury (AKI) is usually managed through renal replacement therapy (RRT). According to evidence, RRT should be considered when renal capacity cannot guarantee a sufficient metabolic, electrolyte, and fluid balance. Once the initiation of RRT has been decided, physicians must address the vascular access placement and prescribe the modality, the dose, and the anticoagulation of the treatment. As RRT should be tailored to the patient, initial prescriptions should be varied according to the current patient’s need. Once the acute kidney insult has been solved, a full, partial, or no renal recovery may occur. Hence, different degrees of chronic kidney disease (CKD) may persist. It is generally accepted that AKI and CKD are closely linked in a highly complex relationship. The development of AKI and the worsening of CKD might recycle in the patient life until end-stage renal disease.


2019 ◽  
Vol 13 (1) ◽  
pp. 17-23
Author(s):  
Cédric Pinier ◽  
Philippe Gatault ◽  
Laurent Fauchier ◽  
Denis Angoulvant ◽  
Maud François ◽  
...  

Abstract Background Interconnections between major cardiovascular events (MCVEs) and renal events are recognized in diabetes, however, the specific impact of atrial fibrillation (AF), heart failure (HF) and acute coronary syndrome (ACS) on the risk of end-stage renal disease (ESRD) on top of established renal risk factors is unclear in type 2 diabetes mellitus. Methods We conducted a retrospective study in 861 consecutive patients followed in a nephrology setting during the 2000–13 period. Results The mean age was 70 ± 10 years, 65.1% were men and the estimated glomerular filtration rate (eGFR) was 42.4 ± 21.0 mL/min/1.73 m2. During follow-up (median 59 months), 194 patients reached ESRD. A history of AF, HF or ACS was associated with an increased risk of reduced baseline eGFR. In turn, reduced baseline eGFR resulted in a greater risk of new MCVE (especially HF) during follow-up. Finally, all new MCVEs were risk factors for subsequent acute kidney injury (AKI) {HF: hazard ratio [HR] 8.99 [95% confidence interval (CI) 7.06–11.4]; AF: HR 5.42 (3.91–7.52); ACS: HR 8.82 (6.24–12.5); all P < 0.0001} and ESRD [HF: HR 5.52 (95% CI 4.01–7.60), P < 0.0001; AF: HR 3.48 (2.30–5.21), P < 0.0001; ACS: HR 2.31 (1.43–3.73), P = 0.0006]. The AF- and HF-associated risks of ESRD were significant after adjustments on all renal risks of ESRD (gender, blood pressure, eGFR, albuminuria, renin–angiotensin blockers, retinopathy and AKI), but the association was less strong for ACS. Importantly, no association was noted between other major events such as stroke or infections and the risk of ESRD. Conclusions Past and new cardiovascular events (more HF and AF than ACS) have a strong, independent impact on the development of ESRD above and beyond established risk factors in diabetes.


2011 ◽  
Vol 80 (9) ◽  
pp. 970-977 ◽  
Author(s):  
Florence Sens ◽  
Anne-Marie Schott-Pethelaz ◽  
Michel Labeeuw ◽  
Cyrille Colin ◽  
Emmanuel Villar

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